Extreme Poverty and Ill-Health
by Roilo Golez, 2014
Per the National Statistical Coordination Board, 27.9% of the Philippine population fell below the poverty line in 2012, with per capital income below $1.25 a day.http://en.wikipedia.org/wiki/Poverty_in_the_Philippines
For the poor, basic medicines are beyond reach, a documented by “Medicines beyond reach” observing the following: (http://opinion.inquirer.net/33107/medicines-still-beyond-reach-of-many)
“The results,indicate that ...drugs are... prohibitive for the unemployed and indigent.”
A WHO survey found the average cost of a prescription for acute illness was $11.27, nine days income for the poor; monthly cost of medicines for chronic diseases was $22. Any kind of illness or chronic disease is a life or death proposition.
On the other hand the well off can easily buy a Starbucks cappuccino for P115 or $2.67 which is two days income for the poor. The very well off can buy a P600 lunch ($13.90) or 11 days per capita for the poor.
This photo shows the deep contrast between the well off and the poor in Metro Manila:
How poor families live:
And the contrast between the rich in tall condominiums and the poor in slums:
Per the National Statistical Coordination Board, 27.9% of the Philippine population fell below the poverty line in 2012, with per capital income below $1.25 a day.http://en.wikipedia.org/wiki/Poverty_in_the_Philippines
For the poor, basic medicines are beyond reach, a documented by “Medicines beyond reach” observing the following: (http://opinion.inquirer.net/33107/medicines-still-beyond-reach-of-many)
“The results,indicate that ...drugs are... prohibitive for the unemployed and indigent.”
A WHO survey found the average cost of a prescription for acute illness was $11.27, nine days income for the poor; monthly cost of medicines for chronic diseases was $22. Any kind of illness or chronic disease is a life or death proposition.
On the other hand the well off can easily buy a Starbucks cappuccino for P115 or $2.67 which is two days income for the poor. The very well off can buy a P600 lunch ($13.90) or 11 days per capita for the poor.
This photo shows the deep contrast between the well off and the poor in Metro Manila:
How poor families live:
70% of the poor don’t have health insurance; hospitalisation would trigger a financial crisis (latest published
report, but this may have gone done with PhilHealth’s effort).
A WHO study shows the following Estimates of Unit Costs for Patient Serviceshttp://www.who.int/choice/country/phl/cost/en/
A WHO study shows the following Estimates of Unit Costs for Patient Serviceshttp://www.who.int/choice/country/phl/cost/en/
Cost per bed day*
$ 2005
$ 2005
Primary $44.92
Secondary $58.60
Tertiary $80.04
Secondary $58.60
Tertiary $80.04
Cost per outpatient visit*
$ 2005
$ 2005
Primary Secondary Tertiary
$14.63 $20.75 $30.70
At $1.25 per day income, the $44.92 for a primary level hospital is way beyond reach.
HEALTH CENTRE COSTS
Cost per visit at health centre for a 20 minute visit**
$2005
50% $8.04
80%$ $8.68
Cost per visit at health centre for a 20 minute visit**
$2005
50% $8.04
80%$ $8.68
* public facility, at different population coverage,
excludes drugs and diagnostics.
A Public hospital
A Public hospital
Hospital for rich
For a government hospital facility, daily cost, without drugs and diagnostics, is more than six times their daily $1.25 per capita income.
That’s why they often incur heavy debt, starting a vicious financial cycle, or opt for self treatment, aggravating the sick's health condition causing death. Funeral costs would be minimum of $279 or 223 days of per capita daily income.
Worse, it is the poor who are more prone to sickness. A 2001 study submitted by Ann Kern, Executive Director, Sustainable Development and Healthy Environments, World Health Organization and Jo Ritzen, Vice President and Network Head Human Development, World Bank (http://siteresources.worldbank.org/INTPAH/Resources/Publications/Dying-for-Change/dyifull2.pdf) opened with a quote from UN Secretary General Kofi Annan: “The biggest enemy of health in the developing world is poverty.”
The report cited the stark realities of poverty and ill-health.
DYING FOR CHANGE
“A. Poor places kill – “Fire of hunger
Public hospital
“Fire of hunger
“You’re never sure what you are drinking “A plague of flies
“Draughty, humid, leaking When children waste and die No one needs us “I look for a job every day“
Here is a video documentary of poverty in the Philippines:
https://www.youtube.com/watch?v=Ylyd_sHgis
Here is a video documentary on the urban poor in Manila:
https://www.youtube.com/watch?v=tOlVAl5TElY
The WHO-WORLD BANK study concluded with these lines dramatizing the intersection of poverty with ill- health, a vicious cycle for the extreme poor:
"WHO research suggests that a small number of conditions affect poor people disproportionately. These include communicable diseases (specifically TB, HIV/AIDS and malaria), childhood illnesses (e.g., measles, polio), and reproductive health problems.
"While Voices of the Poor does not tend to detail the specific illnesses of the poor, it makes clear that bodily afflictions and illnesses are a major concern among poor people. This insecurity around bodily well-being adds to poor people’s mental anguish and stress. When talking about ill- health, both men and women also focus on mental and psychological ill-health – such as the mental stress caused by poverty, powerlessness and discrimination.
"Voices of the Poor points to a serious gap in our understanding of poor people’s mental health
problems, particularly in developing countries5. Even less is known about how to treat such problems: almost all research on the efficacy of mental health treatments – either pharmacological or psycho- social – is based in developed countries, and little work has been done to test the applicability or appropriateness of such treatments to developing countries.
"Strategies are needed to ensure that the health services and interventions offered to poor communities are comprehensive, and maintain a balance between addressing physical and mental health problems. Individual interventions and programs to tackle specific diseases should be integrated as much as possible, both with each other and with health systems, to avoid unsustainable “vertical” programs.
CONCLUSION
"There is growing recognition in both international and national health policy of the centrality of health to economic and social development and poverty reduction. Indeed – many of the conclusions and suggestions made above are reflected the health policies and plans of developing country governments and developed country donors. But in all but a handful of cases this recognition in not being translated into practice.
"Action is needed. Detailed, cross-sectoral policies on how to improve the health of the poor need to be developed. Poor people’s participation in policy development and implementation must remain central. And poor countries and international donors must mobilize the necessary resources to deliver improved health. Governments around the world must respond to the demands of poor people, who are crying out for better health – and dying for change.”
“You’re never sure what you are drinking “A plague of flies
“Draughty, humid, leaking When children waste and die No one needs us “I look for a job every day“
Here is a video documentary of poverty in the Philippines:
https://www.youtube.com/watch?v=Ylyd_sHgis
Here is a video documentary on the urban poor in Manila:
https://www.youtube.com/watch?v=tOlVAl5TElY
The WHO-WORLD BANK study concluded with these lines dramatizing the intersection of poverty with ill- health, a vicious cycle for the extreme poor:
"WHO research suggests that a small number of conditions affect poor people disproportionately. These include communicable diseases (specifically TB, HIV/AIDS and malaria), childhood illnesses (e.g., measles, polio), and reproductive health problems.
"While Voices of the Poor does not tend to detail the specific illnesses of the poor, it makes clear that bodily afflictions and illnesses are a major concern among poor people. This insecurity around bodily well-being adds to poor people’s mental anguish and stress. When talking about ill- health, both men and women also focus on mental and psychological ill-health – such as the mental stress caused by poverty, powerlessness and discrimination.
"Voices of the Poor points to a serious gap in our understanding of poor people’s mental health
problems, particularly in developing countries5. Even less is known about how to treat such problems: almost all research on the efficacy of mental health treatments – either pharmacological or psycho- social – is based in developed countries, and little work has been done to test the applicability or appropriateness of such treatments to developing countries.
"Strategies are needed to ensure that the health services and interventions offered to poor communities are comprehensive, and maintain a balance between addressing physical and mental health problems. Individual interventions and programs to tackle specific diseases should be integrated as much as possible, both with each other and with health systems, to avoid unsustainable “vertical” programs.
CONCLUSION
"There is growing recognition in both international and national health policy of the centrality of health to economic and social development and poverty reduction. Indeed – many of the conclusions and suggestions made above are reflected the health policies and plans of developing country governments and developed country donors. But in all but a handful of cases this recognition in not being translated into practice.
"Action is needed. Detailed, cross-sectoral policies on how to improve the health of the poor need to be developed. Poor people’s participation in policy development and implementation must remain central. And poor countries and international donors must mobilize the necessary resources to deliver improved health. Governments around the world must respond to the demands of poor people, who are crying out for better health – and dying for change.”
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